| NPI | 1538599980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE CARNEY President 434-242-5446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401410463) |
| Enumeration Date | 2013-11-21 |
| Last Update Date | 2013-11-21 |